| NPI | 1487091534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: VA 0101260553) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL TRN18511) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: DC MTL002874) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0101260553) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: GA 11110) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: DC MTL002874) | |
| Enumeration Date | 2013-05-30 |
| Last Update Date | 2022-02-04 |